Objective: To assess 5-year oncologic outcomes of apparent early-stage high-intermediate and high-risk endometrial cancer undergoing sentinel node mapping versus systematic lymphadenectomy. Methods: This is a multi-institutional retrospective, propensity-matched study evaluating data of high-intermediate and high-risk endometrial cancer (according to ESGO/ESTRO/ESP guidelines) undergoing sentinel node mapping versus systematic pelvic lymphadenectomy (with and without para-aortic lymphadenectomy). Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard methods. Results: Overall, the charts of 242 patients with high-intermediate and high-risk endometrial cancer were retrieved. Data on 73 (30.1%) patients undergoing hysterectomy plus sentinel node mapping were analyzed. Forty-two (57.5%) and 31 (42.5%) patients were classified in the high-intermediate and high-risk groups, respectively. Unilateral sentinel node mapping was achieved in all patients. Bilateral mapping was achieved in 67 (91.7%) patients. Three (4.1%) patients had site-specific lymphadenectomy (two pelvic areas only and one pelvic plus para-aortic area), while adjunctive nodal dissection was omitted in the hemipelvis of the other three (4.1%) patients. Sentinel nodes were detected in the para-aortic area in eight (10.9%) patients. Twenty-four (32.8%) patients were diagnosed with nodal disease. A propensity-score matching was used to compare the aforementioned group of patients undergoing sentinel node mapping with a group of patients undergoing lymphadenectomy. Seventy patient pairs were selected (70 having sentinel node mapping vs. 70 having lymphadenectomy). Patients undergoing sentinel node mapping experienced similar 5-year disease-free survival (HR: 1.233; 95%CI: 0.6217 to 2.444; p = 0.547, log-rank test) and 5-year overall survival (HR: 1.505; 95%CI: 0.6752 to 3.355; p = 0.256, log-rank test) than patients undergoing lymphadenectomy. Conclusions: Sentinel node mapping does not negatively impact 5-year outcomes of high-intermediate and high-risk endometrial cancer. Further prospective studies are warranted.

Sentinel node mapping in high-intermediate and high-risk endometrial cancer: Analysis of 5-year oncologic outcomes / Cuccu, Ilaria; Raspagliesi, Francesco; Malzoni, Mario; Vizza, Enrico; Papadia, Andrea; Di Donato, Violante; Giannini, Andrea; De Iaco, Pierandrea; Perrone, Anna Myriam; Plotti, Francesco; Angioli, Roberto; Casarin, Jvan; Ghezzi, Fabio; Cianci, Stefano; Vizzielli, Giuseppe; Restaino, Stefano; Petrillo, Marco; Sorbi, Flavia; Multinu, Francesco; Schivardi, Gabriella; De Vitis, Luigi Antonio; Falcone, Francesca; Lalli, Luca; Berretta, Roberto; Mueller, Michael D; Tozzi, Roberto; Chiantera, Vito; Benedetti Panici, Pierluigi; Fanfani, Francesco; Scambia, Giovanni; Bogani, Giorgio. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - 50:4(2024). [10.1016/j.ejso.2024.108018]

Sentinel node mapping in high-intermediate and high-risk endometrial cancer: Analysis of 5-year oncologic outcomes

Cuccu, Ilaria;Di Donato, Violante;Giannini, Andrea;Cianci, Stefano;Tozzi, Roberto;Benedetti Panici, Pierluigi;Bogani, Giorgio
2024

Abstract

Objective: To assess 5-year oncologic outcomes of apparent early-stage high-intermediate and high-risk endometrial cancer undergoing sentinel node mapping versus systematic lymphadenectomy. Methods: This is a multi-institutional retrospective, propensity-matched study evaluating data of high-intermediate and high-risk endometrial cancer (according to ESGO/ESTRO/ESP guidelines) undergoing sentinel node mapping versus systematic pelvic lymphadenectomy (with and without para-aortic lymphadenectomy). Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard methods. Results: Overall, the charts of 242 patients with high-intermediate and high-risk endometrial cancer were retrieved. Data on 73 (30.1%) patients undergoing hysterectomy plus sentinel node mapping were analyzed. Forty-two (57.5%) and 31 (42.5%) patients were classified in the high-intermediate and high-risk groups, respectively. Unilateral sentinel node mapping was achieved in all patients. Bilateral mapping was achieved in 67 (91.7%) patients. Three (4.1%) patients had site-specific lymphadenectomy (two pelvic areas only and one pelvic plus para-aortic area), while adjunctive nodal dissection was omitted in the hemipelvis of the other three (4.1%) patients. Sentinel nodes were detected in the para-aortic area in eight (10.9%) patients. Twenty-four (32.8%) patients were diagnosed with nodal disease. A propensity-score matching was used to compare the aforementioned group of patients undergoing sentinel node mapping with a group of patients undergoing lymphadenectomy. Seventy patient pairs were selected (70 having sentinel node mapping vs. 70 having lymphadenectomy). Patients undergoing sentinel node mapping experienced similar 5-year disease-free survival (HR: 1.233; 95%CI: 0.6217 to 2.444; p = 0.547, log-rank test) and 5-year overall survival (HR: 1.505; 95%CI: 0.6752 to 3.355; p = 0.256, log-rank test) than patients undergoing lymphadenectomy. Conclusions: Sentinel node mapping does not negatively impact 5-year outcomes of high-intermediate and high-risk endometrial cancer. Further prospective studies are warranted.
2024
Endometrial cancer; High-risk; Intermediate-high risk; Sentinel node mapping
01 Pubblicazione su rivista::01a Articolo in rivista
Sentinel node mapping in high-intermediate and high-risk endometrial cancer: Analysis of 5-year oncologic outcomes / Cuccu, Ilaria; Raspagliesi, Francesco; Malzoni, Mario; Vizza, Enrico; Papadia, Andrea; Di Donato, Violante; Giannini, Andrea; De Iaco, Pierandrea; Perrone, Anna Myriam; Plotti, Francesco; Angioli, Roberto; Casarin, Jvan; Ghezzi, Fabio; Cianci, Stefano; Vizzielli, Giuseppe; Restaino, Stefano; Petrillo, Marco; Sorbi, Flavia; Multinu, Francesco; Schivardi, Gabriella; De Vitis, Luigi Antonio; Falcone, Francesca; Lalli, Luca; Berretta, Roberto; Mueller, Michael D; Tozzi, Roberto; Chiantera, Vito; Benedetti Panici, Pierluigi; Fanfani, Francesco; Scambia, Giovanni; Bogani, Giorgio. - In: EUROPEAN JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0748-7983. - 50:4(2024). [10.1016/j.ejso.2024.108018]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1703681
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